Why /r/ Is So Hard: A Conversation About Speech Sound Disorders with Dr. Kelly Farquharson

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Transcript of “Why /r/ Is So Hard: A Conversation About Speech Sound Disorders with Dr. Kelly Farquharson” – Bright Conversations Podcast

Hi and welcome to another episode of Bright Conversations from Bright Ideas Media. I am your host today, Shontaye Glover-Jones, and it is my pleasure to be joined by Dr. Kelly Farquharson for a special episode where we will get all into speech sound disorders and talking specifically about why art is just so hard. In case you somehow don't know Kelly, I'd love to tell you a little bit more about Kelly. It has been a true pleasure working with her over the years through Bright Ideas.

She is one of the people who is super easy to work with and collaborate with and also someone who's just so knowledgeable but always open and willing to share her information. Dr. Kelly Farquharson is a professor at Florida State University and she's also the director of the class lab. Her research has a mission to help children with speech and language impair ments achieve classroom success. She uses her social media if you're not familiar on the next Friday.

She also shares a lot of important information that's really applicable to your practice today. So if you're looking for more than just theory, you should definitely be tapped into Kelly on social media. And also this episode, I think that you'll find it very insightful. I can say for a fact that I've learned a lot even in watching your most recent course. So I'm excited to chat a little bit more with you today, Kelly.

Well, thank you so much for the warm welcome, Shontaye. And likewise, I have just had a wonderful partnership with Bright Ideas Media over the years. And so I'm just so thankful for your continued collaboration and the opportunity to get to talk about this content and really put it in front of more SLPs to hopefully get it out there and help SLPs really practice more at the top of the license and to really lean into all of that expertise that we have. Yeah. You know, speaking of top of the license and expertise, I do want to point out that we worked together for embracing expertise, which was a series that Kelly collaborated on and helped produce through Bright Ideas Media, where really focusing on some of those topics that we forget were experts in, and that was a fantastic series.

We still have the latest one in our library courses that focus on literacy. So if you haven't checked it out, feel free to check those out. But most recently, we had the honor of having Kelly and Sharon McLeod on to lead our series on speech sound disorders. And that's why we really wanted to have Kelly come back today and answer your questions. You've had some time to sit with the content and now you're thinking about the kids that you actually work with, or maybe you haven't viewed the courses yet, but you still have some kiddos that you're thinking of and not sure what to do.

And so we had a few questions that came in and we'll start with those and then we'll just see where the conversation goes from there. Sounds great. Okay. Yeah. So our first question is, I have been working with a child for two years to correct the pre-vocalic and vocalic R sounds.

She corrected the pre-vocalic R quickly, but is having great difficulty general izing her correct production of all vocalic R sounds to conversation outside of the therapy sessions. At the start of each therapy session, her vocalic R is very distorted. After practicing the sounds using speech motor training, she is able to maintain correct production throughout the rest of the session with 90% accuracy, including reading and connected speech. She has a profound hearing loss from birth in the right ear. Her motor memory for accurate placement seems very weak.

Any tips to help with generalization? That's a long one. It's a long one and it's loaded. So I feel like this question is a really good one because it's a very common issue that we see with this generalization across different positions for R. So there's a couple things I want to unpack.

First, I feel like the person asking this question kind of buried the lead a bit with the profound hearing loss because that I would have led with that part in this question of this is a student with a profound hearing loss because I'll just be really frank. If there are not amplification options for this child and there might not be for a variety of reasons related to parent choice, child choice, there may be anatomical reasons why hearing amplification is not in place and I don't know whether it is or not it didn't necessarily say and I know it's unilateral. However, speech perception for R needs to be like really high quality and so we don't necessarily know what this person's speech perception is, but I will say it can be markedly weak if there's a hearing loss, even just one sided hearing loss. If it's profound, that's going to change what kind of input this person can have. And so just to be totally frank, it is a possibility and I don't think we talk about this enough.

It is a possibility that this R is distorted for a while, that this is a challenge for a long time for this person because of the hearing loss. So what I want to kind of set that out first as a real possibility of a prog nosis. That's not to say that I would give up or that there's no reason to keep trying . I don't think that and I don't know that we have an age on this trial, is that right? We don't, they didn't buy the age.

So that's another thing. Yeah, and the only thing that would make me wonder regarding the age is just like how long have they been working on this? Because if we're talking about a teenager who's been working on it for perhaps 10 years, we may need to take a break and revisit if this is a priority and maybe it is. And so with that in mind, I think that's the first thing. The second thing is I really thought it was interesting that the motor memory piece seems to be weaker.

There's a lot we don't know about motor memory and it's really hard to measure. So I wouldn't necessarily go there yet if we know that there's a hearing loss because perhaps it's motor memory, but it also could just be phonological memory because the input is weaker. So that's something else to keep in mind. The next thing I wanted to talk about with this question is the difference between Prevocalic and Vocalic R's because a lot of times it's assumed that those are the two ways you can make R, Prevocalically and then Vocalically. So Prevocalic meaning before the vowel and Vocalic meaning, you know, kind of encompassed with the vowel, maybe even calling it post-Vocalic.

But these are the vowel sounds, the rodic diphthongs or vocalic R's like ear, air, air, or er, er. And a couple of important things to think about there is that it's not just Pre vocalic and Vocalic. Each one of those Vocalic R's kind of needs a different tongue position. And so one of the things that I talked about in my presentation is, you know, our mascot for this facilitative context product is this little octopus, flirty-gurdy. And the reason for that is because the way that the human tongue operates is very similar to the way that how it octopus's tentacle operates.

They're both considered muscular hydrostats. And that means they basically are constantly shifting and displacing muscle fibers and water. And they have a lot of flexibility and are very nimble. And so the difference between ear, our tongue is likely to be a little bit more anterior in the mouth because E is a high front vowel. And so in order to get that placement for E, the R is naturally going to be produced a little bit more anteriorly in the mouth.

By comparison to R, the AR, rodic diphthong or vocalic R, that is a low back vowel. And so our tongue is actually going to be way farther back in the mouth for the vowel. And therefore the R itself might actually be more posterior as well. So there's a lot of differentiation there. So I wouldn't expect, necessarily, a pre-vocalic R to generalize into other vocalic R contexts.

I also wouldn't necessarily anticipate that one good vocalic R, so if OOR is a good context for a particular child, I would not necessarily anticipate that that would generalize to other vocalic R's. So that's one thing to keep in mind. And in terms of actually working on the process of generalization, after we have kind of understood that each of those vocalic R's is going to be a different, you know, minutely different, but different enough for some kids. The kids we're thinking about really, it is a pretty drastic change in their mouth posture. So once we're realizing there's more like seven positions there for those vocal ic R's, the other thing that I like to do in a kind of a good trick is the coartic ulation trick that I learned from Lindsey Hookle.

And she's a Texas based SLP and she developed the R coarticulation deck with the Bjorm team. And I'll make sure you have the link for that. Yes, we'll add to our show notes. Yeah. And so it's actually meant exactly for this situation where a child has pre-v ocalic R, but they don't have the vocalic R because what Lindsey has done is just really, it's very creative and really innovative where she has built these word lists.

So for example, a pre-vocalic R word like row. And then she has all of these other words that you can tack on to the beginning to kind of essentially create through coarticulation a medial R. So the one word might be burr and the other word is row. And so the child has that pre-vocalic R, but they don't have the R at the end of burr. But by pulling those together, if they have a good R at the beginning of row, you're kind of creating a situation where they have to have a good R at the end of burr, right?

To put together for burrow. And so she has this whole deck that is really strategic in terms of building these word pairs that create new words. So it builds on a child's ability to produce the pre-vocalic R and then creates a situation where the context is medial vocalic R. And so another example would be a word like rent. And so then she would pair war, warrant, and tire, tyrant.

And so kind of, you know, each word stands alone by itself, but when paired together, it can really bridge that pre-vocalic R. And it's a really nice trick, just kind of relying on language and what we know about language to pull in what the child can do. So this is a pretty complex case. I was glad to hear that this person is working on speech motor chaining because that's a really effective approach that I would also recommend. And really the co-articulation strategy does kind of build on that forward and backward chaining a bit.

So it's a nice strategy to continue to build on that. I actually have watched some of Lindsay's videos and it really does work those co-articulation tricks that she shares. She does a lot on her rock the R page, Instagram, her own website. So I think she's a wonderful resource if you are looking to get some help and some insight. And I think you touched on something that's super important to remember, you know, just because a child may have that vocalic R in one context does not mean that it will generalize over to all of the others.

I can speak very easily. Yes. Right. And you touched a little bit about on chaining. And I know this question talked about chaining too.

But for anyone who's not familiar, can you just talk a little bit about what ch aining means? And I'm sorry, my puppy snuck in while you were chatting. No problem. So I'm going to go put him back out while you just talk a little bit about what chaining is. Sure.

Yeah. Well, and I'll also direct anybody who really wants to know more about this idea of speech motor training. I'll send you a link to the Speech Production Lab at Syracuse University. This is run by Jonathan Preston and also one of his project managers, Megan Le ase. They both also are experts in this area and have done a lot of really incredible work.

And so the idea of motor chaining is really kind of presenting a word and then building on that word. And so one way you can kind of think about this in terms of build upon words is thinking about lay lady ladybug, right? So that's not specific to R, but the idea is that you're building a word that would be forward chaining, where you're kind of building a word by adding a syllable. But each time you add a syllable, you get a real word. It's still real words.

So lay lady ladybug, one, wonder, wonderful. And so you're kind of chaining all of those together to build the ability to produce multisyllabic words. And then there's ways to do backwards chaining to where you're starting with the end of the word and you're kind of reverse engineering the word as well. And so either one of those are really great ways to build on what the skills that a child has, especially because in a lot of context or for a lot of situations, you know, working on the sound and isolation is only going to be so effective. And there are certainly times that you need to work on a sound and isolation, but most treatment approaches, including those that are motor based, you're starting at the word level and you're kind of living at the word level.

And there's very few treatment approaches that require you to just segment one phoneme and then spend weeks and weeks and weeks and weeks and weeks at the isolation level. And I know that you're, if you're kind of climbing that speech ladder that's more like a vanriper approach, you might be thinking like, you know, you have to go isolation syllables, words, phrases, sentences, but you don't. Most treatment approaches do not require that you climb that ladder. And so I think we can just start at the word level and that's another important thing to keep in mind that will also help with generalization. Yeah, yeah, definitely so.

Thank you. I'm going to hop over to our next question about lateral bracing. Lateral bracing and ton root retraction are the two most common aspects of R. I am queuing modeling teaching. What are your favorite cues, models, examples when treating R that address these two elements, making these components concrete for students is something I am continuously looking to improve.

Yeah. That's a great question and I'm glad to hear that, you know, you're thinking about these different important tongue postures because what's interesting about those two in particular, the lateral bracing and the tongue retraction is that they are almost the opposite, they almost require opposite movements of each other because for lateral bracing. So what we're referring to is the lateral edges of the tongue bracing against the palate or the molars in some way. So depend a bit, there's going to be individual differences regarding your mouth anatomy. For me, when I'm lateral, when I'm engaging in lateral bracing, the sides of my tongue are bracing against basically the bottoms of my upper molars.

And so for some people, it may be more like the insides of your upper molars and for others it might be direct contact with the palate. Either way, the point is your tongue is elevated and the sides of the tongue are bracing something on the roof of the mouth. So whether it's palate or molars, edge of molars, inside edge of molars, that's lateral bracing. And so in order to get that tongue placement, I'm not saying I don't use cues and prompts but I really rely on the building a word list that facilitates that for me. And so that is the purpose of our facilitative context therapy deck with Bjorm is that we have created situations in which if I need the tongue to be elevated for lateral bracing then I want high vowels or I want other contexts that are going to trigger an elevated tongue.

So we have an alveolar context where we have TR and DR in the initial position of words or the onset of the syllable or T-E-R-D-E-R at the end of the word to kind of trigger that elevated tongue posture that you would get through using either a high vowel or using another alveolar that would elevate the tongue. And so what I will say is once I have kind of prepared a word list that ensures that this is the tongue posture that I'm going to get, I will try to cue the child in to what they should be feeling. So if a high vowel is E, so two of the highest vowels that we have in English are E and U. E is a high front vowel, U is a high back vowel. So with U you're going to get lip rounding.

And depending on the child you may want to be avoiding rounded vowels for a while if they are doing a W for our substitution. So I kind of my default if I don't know where to start or if no context is facilitative, I will start with a high front vowel. So E is kind of my go-to vowel. So if I have like read, read, reach, remote. So thinking about creating that context and then I'll try to have the child kind of like freeze their mouth posture.

So let's say read and they should be able to kind of feel when you get to the E I want you to stop. And I want them to just freeze and feel where their tongue is because it's not really physiologically possible to produce the vowel E it's a high front vowel. So your tongue will be high front if you're producing the vowel E correctly. So that's one thing that can be helpful is really building a word list that does some of that work for you. And then helping the child realize you know kind of using that as you're prompting cue after the fact.

It is in the position it needs to be because it has to be. If you're making the E sound your tongue has to be elevated. And so kind of relying on that is one area of recommendation. And then the second posture that was discussed in this question is tongue root retraction. And so by contrast to lateral bracing for tongue root retraction, the lower the tongue is in the mouth, the more the tongue root is retracting.

And the farther back in the mouth, the tongue or the vowel is the more the tongue root retracts. So all is our lowest back vowel and that's going to trigger the most tongue root retraction. But if we need to work on both lateral bracing and tongue root retraction, lateral bracing needs high vowels, tongue root retraction needs low vowels. So if in the same child you need to work on both of those things that can be really tricky and you should know that you may not necessarily get a good R for a while, but if I were to balance those and figure out where do I start, I would start with the lateral bracing side of it because tongue elevation is the most important thing to foster in getting a good R. And we can work on developing that tongue root retraction for the lower vow els later, but starting with the higher vowels and really leaning into that tongue elevation is going to be the most important.

So it really is more about facilitative context and less about telling the child to put their tongue somewhere. That's the great thing about our facilitative, the idea of facilitative context , but this deck in particular is that it doesn't really require you to give a lot of complicated prompts and cues because the word list does that for you. Their tongue has to be low in the back of the mouth to be able to produce this sound. Their tongue has to be high and in the front of the mouth in order to produce this sound. And then the R kind of travels around with it.

So we do want them to be able to eventually have a good R with high front vow els and have a good R with low back vowels. But if those are the areas that they're struggling with, the same child is struggling with, I think stabilizing the lateral bracing first may be more important and then move on to getting those lower back vowels and the trick will be, you know, it's possible because we all, all of us who can make an R can do it, but the trick will be for the low back vowels is that it's a pretty quick motor movement to go from the low back vowel to the R. So it's a pretty quick, you know, the elevation does happen when you're saying R, you know, you do kick your tongue up pretty quickly. But if that is an area of weakness, then I would maybe hold off on that until the lateral bracing is better established, but if those are two separate kids, then I, again, I think the high front vowels are going to get you the lateral bracing, the low back vowels are going to get you the tongue root retraction. And so kind of try to stay there until that sound is stabilized a bit.

And it does, it can make for a bit of a boring session, sometimes when you only have one vowel context that you're working on, but really thinking of ways to, you know, make it a little bit more interactive and, you know, but you really only have like five or six words that you need to work on in order to kind of stabilize that motor movement. Yeah. Yeah. And when you're working with younger children, you know, this question doesn't mention the age, but I think it's often difficult because they don't have that perspective to tell you where they feel their tongue. So exactly.

So the cues that you discussed and having those word lists really do make a difference because you're doing a lot of that work for them. They can't say what they feel or where they think that's okay. That's right. And that's the point too, because I'll say even, you know, teaching phonetics and teaching, you know, I teach an undergraduate phonetics course and I teach graduate speech , sound disorders courses. And I've been so lucky to have just incredible students over the years.

And one thing I notice is when I say like feel where your tongue is, even as adults or young adults, they're, they have a hard time with that proprioception of being like, where is my tongue? You know? And so even just today, asking a student like, so what would be, why would the e sound be facilitative? Where's your tongue? And she was not able to tell me.

And you know, so that's not anything, you know, against that student or any student. Right. It is, it is a difficult task to proprioceptively be able to tell like, where is my tongue? And then as soon as you start thinking about it, you move where your tongue is, you know? And so you're then kind of feeling around and it doesn't necessarily stay exactly where it is.

It's a very hard task to ask a student, where is your tongue, particularly for a liquid sound like R, that, you know, your tongue moves around quite a bit. Right. Yeah. And it's difficult for them to see what you're doing in your mouth as well. I just think that it's great that that work has been done for us as clinicians.

If you're interested in taking a look at those products that Kelly was mentioning, they're, it's really helpful just to take some of that legwork out of it all for us. Yeah. Yeah. So thank you for answering those two questions. I wanted to talk about something else that you mentioned during your course.

You talk a little bit about all the variations and the dialects. I think that the Boston dialect is one that we talk a lot about. And I was sharing with Kelly that I am from Northern New Jersey, born and raised. And I didn't know until I left New Jersey that apparently there's an accent that is specific to the county that I grew up in before becoming an SLP, like in a gap between graduate school and finishing undergrad, I used to work for the national highway traffic safety admission. Oh my gosh.

Yeah. And I used to teach child protective safety courses, which would take me up and down the east coast. And one time, I think I was talking about the Ford Explorer. And now I'm saying it like, oh yeah, but I didn't say it that way when I was just talking and doing my thing. I said, Explorer, and they were like, where are you from?

And I was like, what do you mean? Why would you be asking me that question? And so I realized now with more time and experience and being around other folks, I can hear it that sometimes us Northerners, we will delete an hour. Sometimes we will insert an hour and Kelly touches on that when she's talking in her course on all about R. So I want to chat a little bit about that and whether it's considered a dialect , is it a disorder?

Is it something that you would target if you were encountering little Chante in school back in the day? Yeah, these are great questions. And this is actually something that I really have become so passionate about thinking about and talking about, which I'm also just very thankful to the Bjorm team and to you all for giving me this platform and this opportunity to talk about these things and kind of nerd out about it. So yeah, it is a dialect. I will say, so we kind of refer to like my dialect of English and regardless of who you are and what language you speak, you speak a dialect of that language, regardless of where you live, where you grew up, you speak a dialect of your language.

So I'm a native English speaker, monolingual, unfortunately, I grew up in Pittsburgh but have kind of lived all over the country. So I feel like my dialect at this point is fairly neutralized, but there are moments of Pittsburghese that kind of rise to the surface. But regardless, there are dialects of every language and every speaker uses a dialect. So we then kind of dichotomize those dialects into Rodeck or non-Rodeck. So Rodeck dialect is like mine where the R, producing R is required.

So my dialect has R in all word positions. And so I won't, I don't drop an R ever. I mean, not on purpose, right? So everybody has, you know, speech blunders, but there's, my dialect has what we call an obligatory R, the R is obligated in all contexts. In a non-Rodeck dialect, which really just Eastern American is kind of one dialect.

And if there's, you know, you definitely know that if you are a Boston speaker, a speaker of Boston English, you know the difference between Boston English and New York English or New Jersey English, right? So you can hear those differences. So you probably hear the difference in someone who's from Boston, right? But those can also kind of in a way be grouped together as, you know, almost North Eastern English dialect. And so those are, there's variability, but in general, those are non-Rodeck, meaning that there are certain contexts in which R is not required or it is not obligated to produce an R in certain contexts.

Almost all of those, and then that's just the US, there are parts of the Southern part of US, some Southern dialects, so some Louisiana, some Cajun Creole dialects, some of those also have non-obligatory R. And then leaving the US, British English, Australian English, New Zealand English, South African English, most of those are also non-Rodeck or non-obligatory R. But the real trick is that it is in certain context, so it's not the case that you drop an R, drop all the R's and just have no R's. In particular, and I think I'm right about this, in all of those, pre-vocalic R is obligatory. But would never be the case that, you know, in Boston, you'd say that you root for the wed socks, right?

It would be the red socks. So that R, that pre-vocalic R before the vowel, is required. And I believe that's the case for all of those dialects. I don't know that, I'm pretty sure that that's the case for all of those dialects. So I look to anybody to please correct me if you speak a dialect, and I'm speaking incorrectly about your dialect.

But I think it's an important thing to know about because I moved here to Tall ahassee, Florida, from Boston. And one of the things I learned about when I was living there and doing research there is, you know, a lot of kids who can't say R, in the schools in Boston weren't getting services because they're like, that's part of the dialect here, is not part of the dialect to not be able to say R at all, right? People in Boston can and do say R. People in New Jersey can and do say R. People in your county, right?

People in New York can and do say R. And so it's certain context where it's not obligated. And that's usually a vocalic context, but it's really specific. And I go into a lot of detail about this in the session, but it's basically serving as a boundary between consonants and vowels. So it depends on if there's a consonant or a vowel that comes after the word that after the R as to whether or not the R is dropped or preserved.

And then we actually did build in the facilitative context for our inventory. So these are two separate products, but they can be sold bundled together. We actually have dialect sensitive phrases in this. You can think of it as a screener, but we purposefully didn't use the term scre ener because we didn't conduct any psychometric properties to kind of look at, you know, it's not norm referenced or anything like that. But these dialect sensitive phrases are built so that there's 14 different phrases.

And then it should be the case that if I'm testing little Chante, you should have an R in half of these phrases because the way that the dialect works is that the R is preserved before a vowel. And so in car keys, you might drop that R, but in car opener, you would likely preserve it. And there's going to be variation person to person to. But the goal of this is that we have these 14 phrases that you would ask the child to produce. And if it's a dialect, they should have an R in 7, roughly 7 out of 14 because if they're following that dialect rule, it's that there's an R before a vowel.

And so they'll keep that R before the vowel, but drop it before the consonant. So the phrases are paired so that you can kind of examine that to see. So if it would be a delay or disorder, now this is not meant to diagnose. So you know, you'd have to still do your due diligence to get more data there. But if all 14 phrases, there's no R, it's not likely that it's a dialect.

So we kind of built that so you could kind of screen that out almost, you know? Yeah, that's helpful too. If you're trying to figure out what this pattern is that you're seeing because you have this child that's producing the R, but it seems inconsistent, that's helpful to know . So you understand why it's encouraging what the inconsistency actually is. Right.

Right. And of course, you know, it's, I always say we want to talk to the families too . We want to talk to the parents and ask questions about if this is their dialect , but it's also been my experience when I asked a family what their dialect is they don't know, you know? And so, you know, I, again, because I have been so lucky to teach so many wonderful students, there's been many times that when I talk about dialects in class, it is the first time students are learning that they speak a dialect. They're like, well, I don't have a dialect, I'm like, if you are a user of spoken language, you do have a dialect.

In fact, I believe there's even dialects in sign language, right? Oh, wow. So, which is really fascinating. So like, you know, there's differences if it, so if you're a user of language, I should say, I should say, you have a dialect, you know, and so you may not be as familiar with, you know, you, you don't sound different because you sound like everyone around you. But everyone around you speaks that dialect, you know, but then if you go to another part of the country or world, which I highly recommend, you'll start to see that there, you know, there's variability and there's, there are dialects everywhere.

Yeah. Yeah, it's helpful when you are able to speak with the parents when you're working with little children, but sometimes, you know, if you're a school base, you may not have access to meet with the parents, but I find that to be true. Most people don't think that they have an accent myself included. I've noticed too, I ask a family if they speak AAE that don't tell me no because that's just the way that they talk. They don't recognize it as an accent or a dialect.

So something to do. I had a very similar situation where I asked a family if they, if they, if they lean towards speaking more African American English at home and, you know, it, it, I will just say it was actually not a very positive exchange with this family. They were, they were almost offended that I asked the question, you know, which I fully understand and that this is an example of, you know, just continuing to learn important life lessons, but, you know, as a white woman approaching a family and asking that question with, with, you know, has taught me a lot about the sensitivity around that, but also to be able to explain why it matters of like your speech might sound different and it's part of your, of your social dialect and that's, that's normal, it's another, there's nothing wrong with that. It's a, it's a rule governed language, like any other language, but it, it helps us to understand what we're actually testing for because one, one thing we'll see in some examples of African American English are some clusters are reduced in ways that are rule governed that are totally normal and don't need, you know, does not mean that that person needs therapy or services, but if we, if that's not the dialect they're using, then we might think differently, like, oh, they're reducing clusters and that that's not part of their dialect. So we want to maybe then provide services.

So it, it is important to know, but it is not necessarily something that everyone's well aware of like, I speak this dialect or I don't, you know, I agree. I agree. And I've encountered the same thing too, where sometimes it's not the most positive exchange in the beginning, because you, you're, you're educating them on something as well, but also informing them that I'm not asking because I think it's disordered. I just want to recognize that this is a normal language, and make you more informed so that also the educators and anyone else who encounters a child recognizes like, this is not something that needs to be treated. Right.

Right. Yeah. And you, you just mentioned clusters and I'm glad that you did because I wanted to chat just a teeny bit before we went out of time about something you discuss with using clusters for treating R. Yeah. Yeah.

So, so clusters, and this is, you know, I have some unpopular opinions in the field and this may be one of them, but what I will say is like clusters are a, they're a very complex linguistic and motoric unit, so it's always going to be both a language, you know, we use language when we're producing clusters and there's motor movement, so it's always going to be both, but there has been a lot of work showing that working on consonant clusters is effective because it, you're tapping into that coarticulation and it puts that R in the context of a real word and kind of works at a level of complexity that triggers the development of less complex structures. So working on R in clusters can be really effective. Now it's, it's not unlike working on an R in isolation or working in R in, in pre-vocalic context, you know, word initial context where it's still going to take a while, right? So it doesn't change the fact that it might take a while to get there, but the nice thing is once you get R in a cluster and I'd argue it will, it will take less time than if you're just working on R in isolation, but if you're working on R in a cluster, it's very likely to generalize more to other clusters and then also to the singleton levels such that you're not necessarily targeting R by itself, at least pre-vocalically, it still might need some attention vocally because of everything we've, you know, we've discussed, but yeah, it really does create a facilitative context. So in both this screener and in this therapy deck, we include a lot of R clusters, not all of them, because not all of them are facilitative.

So we really have focused on alveolar, so TRDR, and velar, KRGR, as most facilitative. But for a lot of kids, just it being in a cluster is facilitated by itself and I will say that some of the pushback I get on that unpopular opinion is like, well, kids aren't old enough to do that. And I'm like, they are clusters developed very early to, you know, if you've been around typically developing kids, which, you know, I don't have, chose not to have children, so then being around typically developing kids, I'm always shocked how early speech segments develop because it really is early kids, you know, who are two and three are making consonant clusters all the time really without thinking about it. And so they can do it and often we're the ones as the clinicians getting in the way of that and saying like, oh, they're too young, I shouldn't be working on this yet. If other kids their age can do it, then so can they.

And so we can work on this really at any age, but I'd say if it feels more comfortable to not start that till five, that's fine. But working on it at five is absolutely age appropriate. Yeah, I thought that that was really enlightening when it came up when to start working on clusters during the speech sound disorder series, highlight that that entire event, the courses from Sherry is from Kelly as well as the courses from Sharon McLeod are available on demand now. If you have the availability and the capacity, I highly recommend registering for them. Once you access them, they're yours for life to watch over and over again, a lot of really great information that will definitely elevate your practice when it comes to how you think about speech sound disorders and the children and adults that you might interact with.

And we're recording this right now in early November, a lot of this you may see or hear if you're attending the ASHA convention, but the wonderful thing is, if you're unable to make it to the convention, for whatever reasons, you can still access a lot of this important information and education by taking these courses in the speech sound disorder series and we're honored that we were able to have you both to lead this series for us this year. Well, thank you for asking. It was an absolute blast and it was a true honor to work with Sharynne and she and I have a lot in common and have very similar viewpoints on speech development and disorders, but I learned so much from hearing her present and working with her in the development of that and then of course her other pre-recorded session with her colleagues is just exceptional. And so thank you for the opportunity. You guys are always ready and willing to put good evidence out for the SLPs and we all benefit from that.

So thank you. Appreciate that. If you'd like to learn more and if you'd like to hear other conversations, you could head to our website at bethebrightest.com. This show will be uploaded very soon and we'll be sure to include all the fantastic resources that Kelly mentioned today in our show notes so you can access those there. Thank you again for joining us, Kelly.

Thank you for having me.

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